What Is Hypercholesterolemia?

Hypercholesterolemia is a condition characterized by high levels of cholesterol in the blood. Cholesterol is a fatty substance essential for building cells and producing hormones, but too much of it—especially low-density lipoprotein (LDL or “bad” cholesterol)—can increase the risk of heart disease and stroke.

What Causes Hypercholesterolemia?

Hypercholesterolemia can be inherited or lifestyle-related:

• Familial hypercholesterolemia is a genetic condition passed down in families.
• Lifestyle factors such as a diet high in saturated fats, lack of exercise, smoking, and obesity can also contribute.
• Certain medical conditions like diabetes, hypothyroidism, and kidney disease may raise cholesterol levels.
• Some medications, including corticosteroids and beta-blockers, may increase cholesterol.

What Are the Symptoms?

Hypercholesterolemia usually has no symptoms, which is why it’s often referred to as a silent condition. Many people don’t realize they have it until they develop complications such as:

• Chest pain (angina)
• Heart attack
• Stroke

In rare cases of severe or familial hypercholesterolemia, signs may include:

• Fatty deposits under the skin or around the eyes (xanthomas or xanthelasmas)
• Cholesterol buildup in the cornea (corneal arcus)

How Is It Diagnosed?

Hypercholesterolemia is diagnosed through a blood test called a lipid panel, which measures:

• Total cholesterol
• LDL (“bad”) cholesterol
• HDL (“good”) cholesterol
• Triglycerides

Fasting may be required before the test for the most accurate results.

What Is the Treatment?

The goal of treatment is to lower LDL cholesterol and reduce the risk of heart disease. This can include:

Lifestyle changes:

• Eating a heart-healthy diet (rich in fiber, fruits, and vegetables)
• Reducing intake of saturated fats and trans fats
• Exercising regularly
• Quitting smoking
• Maintaining a healthy weight

Medications:

• Statins (most commonly prescribed)
• Ezetimibe
• PCSK9 inhibitors
• Bile acid sequestrants
• Fibrates or niacin in some cases

Are There Any Complications?

If left untreated, hypercholesterolemia can lead to:

• Atherosclerosis (hardening and narrowing of the arteries)
• Coronary artery disease
• Heart attack
• Stroke
• Peripheral artery disease

What Is the Outlook?

With early diagnosis and proper treatment, the outlook is very good. Lowering cholesterol significantly reduces the risk of heart disease and improves long-term health.

Can Hypercholesterolemia Be Prevented?

Yes, in many cases it can be prevented or delayed through:

• A healthy diet low in saturated and trans fats
• Regular physical activity
• Routine cholesterol screening, especially if you have a family history of high cholesterol or heart disease